Statins are a class of drugs-commonly used to lower cholesterol levels, cataracts are the leading cause of vision loss in the U.S., and recently, researchers found a connection between the two.
According to the federal Centers for Disease Control and Prevention, more than 20.5 million Americans have cataracts.
In someone who has this condition, protein in the lens inside the eye breaks down, causing the eye’s lens to become cloudy. Common symptoms include difficulty seeing colors and changes in contrast? Include difficulty driving, reading, and recognizing faces; and difficulty coping with glare from bright lights.
Cataracts usually affect one eye first, but gradually affect both eyes. Several factors have been shown to cause them, including long term exposure to ultraviolet light and exposure to ionizing radiation. Overall health also plays a role, since conditions such as diabetes, hypertension, advanced age, and trauma can result in breakdown of the lens protein.
It is estimated that one in four Americans over age 45 currently takes a statin. In November 2013, the American College of Cardiology and the American Heart Association jointly announced new treatment guidelines for high cholesterol that likely will double the number of statin users.
Such a significant increase in statin use makes it even more important to understand the reported link between statin use and cataracts.
Finding a connection
In one of the largest studies ever done,on the subject, results published in the November 2013 issue of JAMA Ophthalmology demonstrate a connection between statin use and cataracts. Jessica Leuschen, MD, of the San Antonio Military Medical Center, Texas, and colleagues compared the risk of developing cataracts between statin users and non-users who were closely matched in other ways, such as.gender and other medical conditions. Results showed that statin users had a 27 percent great er risk of developing cataracts than non-users.
Further analysis found that this risk may be even higher in statin users who have risk factors for cardiovascular disease but who have not yet experienced any cardiovascular disease events such as a heart attack or stroke.
The study concluded that there was a connection between statins and cataracts, but did not show that statin use caused cataracts.
Statins are not the only medication associated with cataract development.
Medications directly associated:
- Oral steroids. Researchers have found a direct connection be- tween the risk of developing cataracts and long-term use of oral steroids, medication often prescribed to suppress inflallmatory conditions such as rheumatoid arthritis.
- Other medications associated with cataract development but for which a definitive connection has not been proven include:
- Glaucoma medications, used to treat a condition in which pres sure inside the eye causes gradual loss of vision
- Psoralens, a class of drugs used with light therapy to treat certain skin disorders such as psoriasis
- Antips ychotic medications such as chlorpromazine (Thorazine), used to treat mental disorde’rs, severe behavior disorders, severe hiccups, severe nausea and vomiting, and certain types of por phyria, a metabolic abnormality
- Medications weakly associated with cataracts but for which a definitive connection has not been proven include:
- Allopurinol, used to treat gout and some kinds of kidney stones
- Tamoxifen, used to treat advanced breast cancer in men and women and early breast cancer in women
- Amiodarone, prescribed for some life-threatening heart rhythm problems (arrhythmias)
- Tricyclic antidepressants, used to treat depression
- Potassium-sparing diuretics (but not other types of diuretics) used to treat high blood pressure and congestive heart failure
Despite the association between certain medications and cataract development, it’s important to remember that many of these drugs can save lives. Statins, for example, are an effective treatment for lowering cholesterol and help reduce risk of cardiovascular disease. In some cases, statins can prevent a heart attack or stroke.
Don’t stop taking any prescribed medication without first discussing it with your doctor. Ask your doctor about risks associated with any medications you take.
It’s also important to remember that even though cataracts may develop as the result of using life-saving medication, they are treatable. In fact, the National Institutes of Health says that procedures to remove cataracts are among the most common and safest surgeries performed in the U.S. This surgery removes the old, clouded lens from the eye and replaces it with a new, artificial one to restore the patient’s vision.
Cataract surgery is an outpatient procedure that requires a few hours and uses a topical anesthetic. Standard procedure involves the surgeon making a, tiny incision in the eye with a manually controlled tool. Through this incision, the surgeon inserts a tool about the size of a pen tip. This instrument breaks the cloudy lens into pieces and is used to remove the pieces from the eye. Once the cataract is removed, an artificial replacement lens is inserted through the same tiny incision. A newer procedure uses the Victus femtosecond laser, which is approved by the Food and Drug Administration for cataract surgery. Using this laser allows surgeons greater precision than the standard manual cataract removal technique.
Weigh risks, benefits
Anyone who uses statins should discuss the statin-cataract association with his or her doctor to weigh the risks and benefits of statin use.
Doctors also can discuss ways to manage cholesterol levels through lifestyle changes, which potentially could allow a patient to avoid statins and their associated side effects altogether.
Protect your eyes
There is no way to prevent cataracts, but there are ways to delay their onset. Schedule regular eye exams according to your age, to detect and problems early. Children should have their first eye exam at 6 months of age, at age 3, again before the start of school, and every two years thereafter until age 18. Children or teens who wear eyeglasses or contact lenses should have their eyes checked every year. Adults ages 18 to 60 need to have their eyes checked every two years, or every year for those wearing contacts or glasses. Adults ages 61 and older should have their eyes checked every year.
Wear sunglasses (preferably wraparound) and a hat to protect your eyes from the sun. Be sure to wear protective eyewear when working with chemicals or dangerous machinery, or when engaging in sports like skiing, snowmobiling, hockey, basketball, and racquetball.
Eat for eye health. Vitamins and minerals in fruits, vegetables, and fish may help eyes age more slowly.
Talk to your doctor if you have a chronic health condition such as diabetes or thyroid disease, which may increase your chance of developing cataracts